=1= Baltimore, Meredith's Apartment
The first thing Meredith chose to do on her first day-off in two months, a record even for her, was to hop in Jackson's car to pick up Sneezy from the doggie daycare after getting a full night's sleep. It had been six months since she became a first-year resident in the experimental accelerated residency program. And it had been two weeks since she declared her double specialization in paediatric and neurosurgery. Norman McCale and Keith Collier was beyond elated to sign off her declaration form. They rushed to get Meredith a new lab coat so she could customize it with embroidered cartoon animal patches Arizona sent from Seattle. The general surgeons, particularly Morgan Meyers, was a little disappointed but not overly pissed off about it. After all, paediatric surgeons still needed to spend a significant time on her service to establish a sound foundation for general surgery. She would still be a general surgeon by training, so what if her title didn't say that? Tom Koracick had been the calmest of them all. He had been expecting her to specialize in neurosurgery sooner or later given her obvious talent and passion. He did let out a small sigh of relief when he received the declaration form, however, saying Helen would absolutely murder him if Meredith didn't end up as a neurosurgeon. What surprised her the most was Darryl Simmons' reaction. The head of trauma who started off on the wrong foot with Meredith when she first began at Hopkins congratulated her sincerely on finding her calling. She had thoroughly impressed him when she took care of Holly through her month-long hospital stay, especially after she resuscitated Holly when her celiac artery graft was infected and her heart arrested. He also said he was looking forward to Meredith's mandatory trauma certification with him, as part of the requirement to maintain their hospital's level-one trauma centre status.
Jackson chose a double board certification in plastics and otorhinolaryngology (ENT) under Mark's suggestion, citing the two specialties went hand in hand. The two residents had found a pleasant company in Mark after he gave up hitting on Meredith. He and Meredith bonded over their mutual childhood trauma that night at the bar. After that, staying true to his words, he gave teaching a real try. However, Meredith was the only one he was willing to teach, citing Jackson and Siever had already formed the plastic posse and he wouldn't want to meddle with that.
Meredith had gladly complied due to the board's requirement to complete a certain amount of hours in all specialties before declaration and she was behind on plastic. Mark let her scrub in on a gender reaffirmation surgery, and even let her lead a calvarial bone graft harvesting for a facial reconstruction. The last case they scrubbed in together was that of Nancy Waters, a pregnant woman who had her right arm completed amputated in an MVC. Meredith was more than impressed about the young woman's courageous decision to move forward in her life and get what she needed without being in a relationship. She saw a small piece of herself in her patient. She comforted her, admired her bravery and told her that it was indeed much better to be alone and feel like a success than to be in a relationship and feel like a failure. She even physically went to the crash site to search for the arms while the hospital was still reeling from all the trauma due to the MVC. After she retrieved the missing limb, she scrubbed in next to Mark for her replantation surgery, and ended up delivering Nancy's baby. Mark was having such a blast at Hopkins that he prolonged his stay, giving Meredith the perfect opportunity to fill her plastic hours. In the end, Mark left Baltimore in such a hurry after receiving a phone call that he didn't even have the time to bid goodbye to his mentor in person.
The trial residency directors from American Board of Surgery and American College of Surgeons were probably the bunch most pissed off about Meredith and Jackson's decisions. They weren't prepared to tailor their baby trial to accommodate one double board certification, letting alone two of them. The directors thought about denying their double board certifications and forcing them to choose one instead, but Keith Collier and both resident's mentors' vehement protests and threat to drop out of the trial all at once had forced them to curb, and instead put in hours and hours of extra work to integrate two specialties. In the end, the board confirmed that both residents have received ample training in basic and emergent patient care as well as outpatient procedures during their internship that they no longer needed to take mandatory shifts in the E.R. after combing through their history. For the first six month of their residency, the duo had also managed to accrue enough time to satisfy their 100-hour requirement of basic training in trauma, general, neurology, urology, OBGYN, cardiothoracic, plastic, orthopaedic, oncology and paediatric surgery successfully. Therefore, for the next year and a half, the duo would concentrate solely on training pertaining to their specialties in their lotted time. The board had also lifted their 40-hour weekly limit, seeing they already exceeded their limit for countless times for the first six months.
In addition to declaring specialty, passing the first six-month mark in their residency also meant the residents would start to rotate in as lead surgeons on selected cases. Their Seattle clan sent over their gifts of celebration, personalized scrub caps they all pitched in. Meredith's was a dark forest green one with Starbucks cups. They found it appropriate that it matched Hopkins scrub colour, and checked all three boxes for Meredith's Medusa nickname, her love for coffee, and her connection to Seattle. For Jackson, they commenced an artist to draw Sneezy's custom cartoon in Disney style and have it printed all over the forest green fabric for his cap. Both of them cried tears of joy when they opened the package, even though Jackson would never admit that in front of their friends.
Moreover, the board was beginning their first semiannual review process. Because of both Jackson and Meredith's high case load and double specialization, they were supposed to spend twice as long in the board officer's office compared to other trial participants. Needless to say, both of them were very run down at this point. But they couldn't have been happier at the same time. They were both having a flourishing career, and on better terms with their family. Meredith mailed her mother her surgery tapes every week and get an essay from Ellis Grey about how she could improve every time. It had taken Meredith's many gentle coaxing and batting her eyelashes at his mom and both grandparents as well as Jackson's long late night conversations about his true calling with his family that the Averys accepted Jackson's firm declaration of plastics as his specialty. After that, Catherine had subscribed him a fleet of journals on the topic of plastic surgery, many with a focus on reconstructive urology and gender affirmation surgeries. Harper Avery, on the other hand, had not so subtly channeled over a few rare plastic reconstructive cases from Massachusetts.
Their friends were doing well, too, even though they were all a little glum after Grace's national ranking plummeted down to 12. For Cristina, she complained and even talked to Meredith about transferring, but later, when she won the surgical contest and got a hold of the sparkle pager, she forgot about the whole ordeal. Her confidence was reinstated, and she was able to get into a lot of cardiac surgeries with her shiny pager. She impressed the chief with a solo thoracotomy to evacuate a massive clot in the right pulmonary artery, which was typically resolved with a lengthy embolectomy on bypass. But considering the patient's severely compromised status as he was arresting on the table, Cristina managed to evacuate the clot more quickly using her approach and saved the patient's life. It forced the chief to reprimand Hanh for her unfair treatment and inept teaching skills. Now, Cristina was the front runner amongst all her fellow residents to do the first solo surgery. After that, Cristina's dead romantic life since Burke leaving her at the altar was revived when a rugged, handsome ginger trauma surgeon named Owen Hunt pulled an icicle from her abdomen on a snowy night. Meredith offered to ask about Darryl Simmons about the guy for Cristina, given the fact they likely deployed in Iraq together. Cristina brutally shut down the idea and denied there was any spark between the crude soldier and herself. However, a couple weeks later, the very same trauma surgeon was employed at Grace as the head of trauma to reestablish its level one trauma centre status. Now she and Hunt were just dancing around each other, fighting their obvious mutual attraction.
As for their other friends, after the remodelling of the basement was complete, Alex traded his room with Arizona and moved into one of the newly established bedrooms in the basement for more space and less rent. He was also ecstatic about another one of Grace's new hires, one of the foremost plastics surgeon from the East coast. He was finally getting the teacher he needed for his career in plastics. George moved in next door to Alex, the two of them shared a bathroom. He had an amicable divorce with Callie and remained friends with Izzie, not as close as before, after their awkward attempt at a romantic relationship. He had also managed to retake the intern exam and finally became a resident, like the rest of his friends. He had befriended Lexie during his second time as an intern, who had moved into the main bedroom with an ensuite bathroom in the basement floor. Meredith paid extra to redo the plumbing at the house so they could accommodate one more spacious bathroom in the basement for morning rush hours or when they have guests over. Izzie and Callie were on bad terms for a while after the divorce, which is to be expected between an ex-wife and her ex-mistress, but her and Erica Hanh's newly budded relationship and her new found friendship with Arizona had made her a lot less bitter. So they managed to mostly maintain a professional relationship at work. Regarding Izzie, she had rekindled her romantic connection with Alex. And much to her satisfaction, Bailey put her in charge of the Denny Duquette clinic.
Meredith would have been in a perpetual joyous mood right now if not for the text she received from Cristina about Lexie being a secret cutter just as she got off her shift last night. She had gotten closer to Lexie after she moved into Mer's house over time, but Meredith still had fears about overstepping, and cutting oneself sounded like a pretty serious accusation. She was deep in thought about what she would do when Jackson pulled up by the doggie daycare. "Still thinking about that half sister of yours?" Jackson asked, "I'd say don't mind so much, it may ruin your only day off." He was never fond of Lexie because of her tie to Thatcher, a man Jackson hated with a passion. He had his reservations when Meredith started contacting Lexie because he had this nagging suspicion that she would hurt Meredith like her father. But per Meredith's request, he had been civil and polite towards her.
Meredith shot him a soft smile, unbuckled her seatbelt and got out of the car to pick up Sneezy before heading to the trails for a long run. She had been aching to do it, craving the clarity she always acquired after pushing pass her physical limits. It was unfortunate that both of their demanding schedule had put a halt to their running tradition. But the pair had decided they would work something out to reintroduce physical activities with Sneezy once they settle into their double-specialty routine .
Meredith felt rather weak after they completed their 20-mile run. Seeing her gasping for air at the end, Jackson laughed, and then scolded her for choosing such an audacious mileage for her first day getting back to running. But Meredith was rather satisfied, she had a plan for what to do. On their way home, Cristina called. She quickly picked up and put her on speaker.
"I knew what three was doing." Cristina said resolutely from the other end of the line. "She has those cuts on her arm because the interns are practicing sutures on each other."
"What the hell?" Jackson couldn't help but cursed loudly, making Sneezy jump a little bit in the back seat.
Meredith was appalled as well. "Oh wow that's pretty wild. Why would they do that?"
"How would I know? Jesus I swear to god these interns are just getting dumber and dumber every year. Mer, we weren't this clueless when we were interns!" Cristina hissed frustratedly.
"So what did you do about it?" Meredith asked.
"I told them to shut it down, whatever it is. God, the audacity to try something so outrageous at a hospital." Cristina muttered.
"Cristina, they're not gonna stop just because you told them to. They know they're not allowed to do it, but they did it anyways. They are eager to impress you so they get picked for the solo surgery. It's the same reason why Hunt and Bailey admonished you guys over the crash victim and the bouquet of corpses. You guys stopped because you had reason, but these interns," She stopped to think of a word to describe their idiocy without assaulting them, even though she was sure Cristina wouldn't mind, but she was including her half-sister in the reference, "They are very green and they are a bit out of their minds, clearly. Just, they're doing it because they don't have enough practice. George took the dummies and you guys hogged the unclaimed bodies. You gotta do something before these over-eager interns screw up big time. They're already cutting each other open and sewing them back together, what if they're itching to try let's say a procedure, or even a surgery?" Meredith asked.
"You're kind of right, they are not the sharpest bunch, I can't really predict what other stupid things they're gonna engage in." Cristina admitted with obvious annoyance. "Stupid suck-up interns."
Meredith chuckled at her antics, recalling when Bailey caught her fellow interns performing unauthorized autopsies and cutting LVAD wires, "Cristina, I know you all are unwilling to place your intern's learning on top of your own learning. It's weird they let you have interns this early in your residency. But do you remember when Bailey got attacked at the M after Izzie cut Denny's LVAD wire? Residents are evaluated based on their interns performance. And I bet right now none of you look too good for any attending that would be evaluating you for the solo surgery. Just… at least give teaching a try? Don't let them start on patients right away. Let them start on dummies and dead bodies. And no, I didn't forget how Hunt and Bailey slandered you guys a couple days ago. But think about it, most of unclaimed dead bodies do get donated to medicine. Where do you think the corpses medical students practiced on came from? Just make sure you do it in a respectful way where you honour their donation, ok? And I thought of the most efficient way for you guys to teach your interns." Meredith said while wiggling her eyebrows at Jackson playfully. "You guys should hold a class. Kind of like skills lab! But you let them practice more practical techniques at a higher frequency on more human-like materials. You guys can rotate amongst yourselves. It shows good leadership and teaching skills."
Cristina snickered, "Damn, Mer, you're actually making sense. That's a fair idea!"
"Of course it is." Meredith sported a proud smile, "You make sure you share it with the others, ok? You can probably spearhead it but you need to share in the end, otherwise they're gonna throw a fit, and you can't do the whole thing yourself anyways."
A couple days later, Meredith and Jackson were glad to hear that Bailey and the chief was more than thrilled about Cristina's proposal. They were glad the residents caught onto such a crazy stunt so early, and were both thoroughly impressed by their solution. The residents kickstarted their own skills lab and Lexie had no more new cuts on her arms.
However, another week passed by, and a couple particularly brazen interns that wanted to get ahead amongst their peers made a heinous move despite their residents warning. They were in the middle of taking out an inflamed appendix from one of their own's abdomen when Cristina and Izzie busted through the outpatient O.R. door. The two female residents finally felt the maniac, all-consuming rage Bailey asserted the day she walked into the morgue or when she trudged through the threshold of Denny's room. They sent one of the interns still standing to find Bailey and the chief, but both were tied in a surgery already. Under such dire circumstances, they took over the surgery right away and expectantly found a bleeding mess on the table. They quickly fixed the blown stitches on the artery on the mesoappendix with ligature sutures and finished the procedure while keeping a running commentary, cursing and berating the foolishness of their interns. The words Izzie spilled out of her mouth that night even brought a new light to herself. All interns, the ones in the outpatient O.R. receiving her fury, and the ones out of the O.R. stalking, had ceased calling her the dud, or the Barbie. The chief and Bailey were glad about how they handled the crisis, and congratulated the two of them on flying solo on an appendectomy. All six interns involved in the incident were put on probation and forbidden from any independent patient contact, only receiving supervised rectals, explosive diarrheas, projectile vomiting, oozing bed sores and abscess for a month.
Three of the six interns punished were Izzie's, while the other three resident each had one intern participating in this ordeal. Izzie felt guilty despite the chief and Bailey's reassurance that she did her best. Three weeks into their punishment, she was beyond finished with her interns constant sullen mood. The kind-hearted resident therefore proposed a game to cheer them up and reignite their inner fire for surgery and medicine. The chief suggested the interns that weren't punished should also get to play, as they shouldn't be forbade from education opportunities because they didn't make a grim mistake. They had an absolutely blast. Lexie, the winner of the game was awarded to scrub in on the transcatheter closure for a patient with pulmonary hypertension and left ventricular hypertrophy, with the potential next chief of cardio Virginia Dixon and Cristina in a week.
=2= Baltimore, Johns Hopkins Hospital, a week later
Meredith was wrapping up her notes from her mandatory psych training session, an integral part of her training for paediatric surgery, when she got a call from Lexie. It had been a slow day for her. She was the last one to begin the semiannual review process amongst all the trial participants, so she had only an early pyeloplasty with Meyers, the psych training and then a review session with her corresponding review officer, Dr. Austin Heathcliff and the rest of the review committee for the rest of the day. A gnawing stomachache had been bothering her since last night. She had drained half a bottle of Pepto Bismol before her nap in the on-call room to soothe it, but a couple hours later, she still woke up from the worsening pain. She had downed the rest of the bottle of pink liquid and taken two capsules of extra-strength Tylenol this morning before the start of her morning shift, hoping it would curb the nausea and the pain until she got off work, but it was only getting harder to bear. She clutched her stomach uncomfortably and put her face on the cool table top as she flipped open her phone.
"Meredith! Cristina got the first solo surgery! It's an above the knee amputation tonight! She was called into the chief's office and asked me to tell you. And Dr. Stevens arranged another contest for us, it was so much harder than the one last week but we cracked it in the end!" Lexie exclaimed happily, eliciting a smile out of Meredith as well.
"That's great. What did Iz plan for you this time?"
"She had us trying to diagnose a mystery patient X, the only clue she gave was an elevated HLD level and hallucinations about her dead fiancé. There were so many times throughout we thought patient X was fine! But Dr. Stevens pushed us till the end, and we diagnosed her with metastatic melanoma with mets to the brain, skin and liver. It was so fun! She also taught me how to break the news to the patient. I learned a lot today." Lexie chuckled.
"That sounds really cool! So what prize did you guys win in the end?" Meredith asked, surprised the amount of work Iz had put into teaching the interns Cristina and Alex had deemed hopeless. She was curious what string Izzie had pulled this time to cheer them up.
"Hmm, we didn't actually get a prize today. She snapped and said the prize this time was that we were able to practice medicine correctly today." Lexie recalled, "I think the crass and the recklessness are finally getting to her." She scratched her head, "That's actually something I wanted to talk to you about. I feel like she was really close to patient X. Some of her reactions today seemed pretty personal, do you know if one of her friends or family was sick?"
"Hmm, I don't think so. I haven't heard about it at least." Meredith rubbed the crease between her eyebrows, wondering what is going on. No one had said anything about Iz to her lately, maybe Lexie was being overly cautious? "How was your surgery with Dr. Dixon and Cristina?" She decided to change the topic. She could circle back to it when she wasn't in so much pain that she wasn't thinking straight.
"Our patient, Tracy Pollock, get in tomorrow! I can't wait, I looked up Dr. Dixon's profile and she is amazing! I hope we manage to woo her." Lexie couldn't conceal her excitement.
"Oops, Sorry Lex, gotta go,I have a meeting right about now. I'll ask Iz about what you said. Thanks for letting me know." Meredith quickly hang up and got up. She felt bile rising in her throat and her head spinning a little bit as she stood up a little too quickly, but she managed to suppress it and rushed to the conference room, which was acting as a make-shift office for the board review officers since their arrival, just in time for her session today.
After her first session was finished, her main reviewer, Dr. Austin Heathcliff called for a coffee break, saying they could all use an afternoon pick me up. Meredith crouched in her chair, pulling out her phone to distract herself from the persistent abdominal pain. She found three un-answered calls from Izzie when she had her phone on silent during the meeting. What the heck? Was there an emergency? Just as she was about to call back, Izzie called once again. She quickly picked up, completely ambushed by the news.
Fifteen minutes later, Jackson was walking down the hall with a cup of hot tea for Meredith in hand. He thought a hot beverage, a tea, particularly, might sooth Meredith's upset stomach. Just as he was approaching the conference room, he saw Meredith stumbling out of the door. Her one hand clutched her stomach while her other hand held onto her phone. She was shaking terribly, and her complexion was white as a sheet. Jackson pulled her into his arms when he caught her glassy eyes. He put a hand on her forehead, she had a high fever. Meredith swallowed the lump in her throat loudly in his embrace before she mustered all her strength and pushed herself to stand straight and looked into Jackson's eyes. She whispered through clattering teeth, "Jackson, Izzie has stage IV metastatic melanoma." Before Jackson could respond, Meredith's eyes rolled back, her body went limp and dropped to the ground. He was able to catch her in his arms, "Get me a gurney over here, STAT!" He bellowed.
A.N.
I got a P.M. saying they would like more frequent updates even if it leaves them hanging. So this is my first attempt at that. Don't worry! I'm not really leaving you on a cliffie! I really needed a break between part 1 and part 2 and I wanted some suspense without killing you guys waiting for more for a long time. So I'm still writing and I will be posting part 2 later tonight. (Sorry, the new chapter is getting way too long and I'm still writing it at this point, which is 1200, please don't wait for it tonight, I suspect it would take me until the early morning hours to finish. I am so incredibly sorry.)Please follow, like, and review, let me know how I did!
I'm writing a more formal author's note acknowledging your reviews and PMs at the end of the next chapter, like Chapter 15/16 Making Peace. Just a preview, I loved them!
Love,
Allis